Abstract
Objective
The authors aim to measure differences in primary care clinicians’ (PCC’s) perceptions of managing pediatric mental health before and after launch of a child psychiatry access program (the access program) and identify the impact of engaging trainees from child psychiatry, pediatrics, and family medicine in administration and use of this program.
Methods
Child psychiatry fellows provide coverage of a grant-funded state-wide access program and engage trainee-peers in learning how to use the program. A survey measuring PCC’s experience managing children’s mental health conditions was administered before and after the child psychiatry access program launched. Rotation evaluations collect trainee’s feedback.
Results
Statistically significant differences are identified before and after the program’s launch in PCC’s perception of access to child psychiatry (U = 294.5, p < 0.001) and between PCC’s perceptions of the impact of behavioral health problems in their patients in those with less than 4 years post-residency training compared with those with 4 or more years post-residency (U = 524.5, p < .01). Trainee evaluation of the rotation is consistently positive (average 5:6 rating).
Conclusion
The authors conclude that (1) the presence of a state-wide access program positively impacts PCC’s reported access to child psychiatry; (2) child psychiatry fellows rate the clinical rotation experience favorably; and (3) there appears to be an association between less time out of primary care residency training and perception of improved access to child psychiatry and less clinical burden from behavioral health issues. Further research is required to understand the impact of a training in this model.
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References
Mental Health America. Youth data 2022. https://www.mhanational.org/issues/2022/mental-health-america-youth-data. Accessed 16 Sep 2022.
Youth prevalence of mental illness. In: the State of Mental Health in America 2021. Mental Health America. 2020. https://mhanational.org/sites/default/files/2021%20State%20of%20Mental%20Health%20in%20America_0.pdf. Accessed 18 Sep 2022.
Youth prevalence of mental illness. In: the State of Mental Health in America 2020. Mental Health America. 2019. https://mhanational.org/sites/default/files/State%20of%20Mental%20Health%20in%20America%20-%202020_0.pdf. Accessed 18 Sep 2022.
Youth prevalence of mental illness. In: the State of Mental Health in America 2019. Mental Health America. 2018. https://mhanational.org/sites/default/files/2019-09/2019%20MH%20in%20America%20Final.pdf. Accessed 18 Sep 2022.
Protecting Youth Mental Health: the U.S. Surgeon General’s advisory. Office of the Surgeon General. 2021. https://www.ncbi.nlm.nih.gov/books/NBK575984/pdf/Bookshelf_NBK575984.pdf. Accessed 16 Sep 2022.
Thomas CR, Holzer CE. National distribution of child and adolescent psychiatrists. J Am Acad Child Adolesc Psychiatry. 1999;38(1):9–15.
McBain RK, Kofner A, Stein BD, Cantor JH, Vogt WB, Yu H. Growth and distribution of child psychiatrists in the United States: 2007–2016. Pediatr. 2019;144(6):e20191576.
Nevada. In: Child and adolescent psychiatrist (CAP) workforce distribution map. American Academy of Child and Adolescent Psychiatry. 2022. https://www.aacap.org/App_Themes/AACAP/Docs/Advocacy/federal_and_state_initiatives/workforce/maps/workforce-maps-all-states-2022.pdf. Accessed 16 Sep 2022.
Comprehensive list of CPAP programs. National Network of Child Psychiatry Access Programs. 2022. https://static1.squarespace.com/static/5f4eb57ede278b5d6b2863c8/t/62df492fa37f6d5e3e28bc9f/1658800442159/CPAPs+Updated+March+2022.pdf. Accessed 16 Sep 2022.
A guide to building collaborative mental health care partnerships in pediatric primary care. American Academy of Child & Adolescent Psychiatry. 2021. https://www.aacap.org/App_Themes/AACAP/docs/clinical_practice_center/guide_to_building_collaborative_mental_health_care_partnerships.pdf. Accessed 16 Sep 2022.
Achkar MA, Bennett IM, Chwastiak L, Hoeft T, Normoyle T, Vredevoogd M, et al. Telepsychiatric consultation as a training and workforce development strategy for rural primary care. Ann Fam Med. 2020;18(5):438–45.
Hilt RJ, Romaire MA, McDonell MG, Sears JM, Krupski A, Thompson JN, et al. The Partnership Access Line: evaluating a child psychiatry consult program in Washington State. JAMA Pediatr. 2013;167(2):162–8.
Straus JH, Sarvet B. Behavioral health care for children: the Massachusetts Child Psychiatry Access Project. Health Aff. 2014;33(12):2153–61.
Best principles for integration of child psychiatry into the pediatric health home. American Academy of Child and Adolescent Psychiatry. 2012. https://www.aacap.org/App_Themes/AACAP/docs/clinical_practice_center/systems_of_care/best_principles_for_integration_of_child_psychiatry_into_the_pediatric_health_home_2012.pdf. Accessed 24 March 2022.
Burkey MD, Kaye DL, Forsch E. Training in integrated mental health-primary care models: a national survey of child psychiatry program directors. Acad Psychiatry. 2014;38(4):485–8.
Child and adolescent psychiatry milestones. The Accreditation Council for Graduate Medical Education. 2022. https://www.acgme.org/globalassets/pdfs/milestones/childandadolescentpsychiatrymilestones.pdf. Accessed 24 March 2022.
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Durette, L., Oden, C., Rudig, N. et al. Clinicians’ Experience with a Graduate Medical Education Implemented Child Psychiatry Access Program. Acad Psychiatry 48, 233–237 (2024). https://doi.org/10.1007/s40596-023-01860-z
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DOI: https://doi.org/10.1007/s40596-023-01860-z